Tag Archives: childhood obesity

In Macbeth, the guilt-ridden titular character of Shakespeare’s tragedy begins to hear auditory hallucinations telling him that he has lost the ability to sleep, and will, for the rest of the play, effectively have become an insomniac. Realising what he’s lost, Macbeth lamentingly lists sleep’s virtues:

Methought I heard a voice cry ‘Sleep no more! Macbeth does murder sleep,’ the innocent sleep, Sleep that knits up the ravell’d sleave of care, The death of each day’s life, sore labour’s bath, Balm of hurt minds, great nature’s second course, Chief nourisher in life’s feast. Macbeth (2.2.46-51)

He couldn’t have been more right. More and more studies are pointing to the desperate need our society has for more and better sleep, as well as to the drastic and rather frightening consequences of not getting it.

How much sleep should kids be getting? The National Sleep Foundation recommends the following:

That’s right; teenagers need more sleep than adults. Not less. But how many of you with teenaged children find that it’s you who are getting more sleep? Oh, sure, teenagers might sleep late on the weekends. But that’s part of the vicious cycle of adolescent sleep deprivation, which according to all kinds of sources, is approaching epidemic levels: here’s a graphic showing how it works.

Taking this one item at a time, it begins with later bedtimes for teenagers. This has many causes, including an apparent circadian “reset” that happens during adolescence. As is usual with such findings, however, it should be taken with a grain of salt, lest we fall prey to the “chicken and egg” fallacy: are the changes in the brains of teenagers the cause, or the result, of their changes in habits? Knowing what we know about neuroplasticity, it’s a question worth asking. More on that later.

Another reason teenagers are staying up later is the reason most of us these days are doing it: there is an unnerving loss of the conditions under which humans have traditionally slept: that is, night. We are losing true nighttime, as I realised in 2003, when I was in New York City during the great Blackout of August in that year. I spent a couple of days sleeping on the floor of the airport, and I was privileged to see what hardly anyone in my lifetime has seen: the Milky Way in the skies above Manhattan. Light pollution has turned nighttime, for the majority of us on the planet who now live in cities, into a kind of a dull glow, or a “luminous fog”, as Ian Cheney puts it in his documentary on the Loss of Night, titled The City Dark.

The body, simply put, needs darkness. The ebb and flow of sunlight in our normal ancestral days regulates melatonin production in the brain. Disrupting this process with light – particularly blue light – has a number of surprising adverse health effects, including cancer, depression, obesity, and heart disease. Yes, cancer – and it seems like light pollution might exacerbate air pollution, too, by killing air-cleansing agents that live only in the darkness! The American Medical Association (AMA) has recognised the important role light pollution plays in detrimental health effects on the population: the AMA, in their Action of the AMA House of Delegates 2012 Annual Meeting, “Recognizes that exposure to excessive light at night, including extended use of various electronic media, can disrupt sleep or exacerbate sleep disorders, especially in children and adolescents.” (My emphasis)
The presence of TV, computer, and now cell phone screens in bedrooms is a major deterrent to normal sleep patterns, as well. And, of course, there are social reasons for teens’ staying up later: they’re building and testing their autonomy away from parental influence.

Unfortunately, although teenagers might try to compensate by sleeping late on weekends, the body’s need for sleep functions something like a bank account: you can run a debt, and it’s cumulative. That means that if you accumulate ten hours’ worth of “sleep debt” one week, just returning to normal sleep levels the next week isn’t going to cut it: You need to regain those ten lost hours on top of it. And the body is an unforgiving creditor, as we shall see.

What are, then, the consequences of sleeplessness? It’s a lot worse than just grumpiness in the mornings, which most parents of teens have experience with. In fact, it’s really, really bad. And the worst part is, we’re not taking it seriously. So it appears that it’ll get worse before it improves. Here’s a graphic that outlines just some of the problems:

Let’s start with the physical consequences of sleep deprivation. As an ex-soldier, I’m familiar with quite a few of them personally, and I remember my acquaintance with them with a great deal of discomfort, even 15 years later. Sleep deprivation contributes to:

Yeah, death. Both because of the reduced immunity (hamsters kept awake died within 3 days), as well as over 100 000 car accidents a year caused by inattention or microsleeps behind the wheel. (Humans can’t stay awake indefinitely; unavoidable moments of sleep called ‘microsleeps’ happen involuntarily not long into prolonged sleep deprivation conditions.) Death by car accident remains the Number One killer of our young people in Canada and the U.S., although our complete surrender to a car culture blinds us to the sheer staggering numbers: In the U.S. in 2010, seven teenagers died every single day in car accidents. Add to that, the number of kids whose health is affected by obesity, as well as the second-biggest killer of teens – suicide, which is of course linked to depression (see below) – and you’ve accounted for the majority of teen deaths in North America, period. Taken together or apart, these are a clear and present danger to our young people.

Bad as those are, the cognitive consequences are just as harmful. Sleep deprivation causes or contributes to:

• Symptoms often mistaken for ADHD, an increasingly-diagnosed disorder in teens
• Reduction in ability to concentrate and pay attention
• Memory reduction and loss, as well as reduced verbal skills (as an English teacher, I see this all the time). This also includes a heavy reliance on simple, clichéd phrases and a crippled capacity for creativity. Uncommunicative, incoherent teens are a cliché themselves!
• Hallucinations (I vividly remember seeing Napoleon one night after many days in the field!)
• Impaired judgement, especially moral judgement: it turns the world into a black-and-white affair
• Depression (also increasingly diagnosed in our teens)
• Reduced ability to cope with negative emotions (the famous ‘moody teen’ syndrome)
• Increased percentages of substance abuse
• Impaired ability to judge and manage risk (which contributes to all sorts of behaviour that adults have blamed teens for in the past)

In our society, where teenagers and adults are generally, chronically, sleep-deprived, it bears thinking about the consequences. From my vantage point as an educator, I can tell two things:

1. I can’t educate sleep-deprived teens. Their brains are too severely compromised for real learning to take place.

2. This is bigger than it looks. Take a good look at the list of cognitive and physical consequences. Apart from hallucinations and death, how many so-called “attributes” of adolescence, as it has been defined by our society, are actually not essential to teens at all, but to sleep deprivation? How many of the current epidemics of ADHD, poor academic performance, depression, moodiness, substance abuse, car accidents, obesity, and poor judgement that we have traditionally looked at individually, might actually be the result, or at least exacerbated by, lack of decent sleep?

As I’ve mentioned in previous posts, teenagers in North America and the developed world are not typical of adolescents in either the rest of the world, or in the historical record. The danger of looking at our teens, who are extreme outliers in terms of behaviour worldwide, as representing some kind of biological or developmental “norm” is a big one. It causes us to look at behaviour which is actually by definition “unnatural”, judge it as ‘normal’, and then adjust our expectations based on a false norm. I see no reason in the historical record or in other cultures I’ve visited to believe that the intensely anti-social, attention-challenged, moody behaviour and crippled judgement capacity that most North Americans associate with the teenage years is biologically based at all. Looking at this evidence, I’m strongly leaning toward viewing all those symptoms as springing from (or at least connected to) a single cause – namely, unhealthy sleep patterns.

In a typically Western fashion, we have ascribed these behaviours to non-contextual categories, and decided that they represent the ‘nature’ of adolescence, rather than seeing them in a broader social, historical, and holistic matrix of contingencies. In a brilliant paper published in 2010, UBC professors Joseph Heinrich, Steven J. Heine, and Ara Norenzayan challenge the practice of making universal generalizations about psychological norms based on studies that are done almost exclusively on American undergraduate students. Heinrich et al. point out that of all the human populations in the world, these WEIRD (Western, Educated, Industrialised, Rich, and Developed) people are among the least likely to represent global norms. In fact, in areas as wide-ranging as spatial awareness, visual perception, moral reasoning, inferential reasoning, WEIRD people are “frequent outliers”, “particularly unusual compared to the rest of the species”. They go on to say in the abstract that “members of WEIRD societies, including young children, [my emphasis] are among the least representative populations one could find for generalizing about humans.” The full paper, available as a PDF here, is well worth reading.

We’re witnessing a number of crises in the mental and physical health of our children, but are we being blinded to a simple solution to nearly all of them simultaneously, because we’ve become so used to the symptoms of the epidemics of obesity, depression, suicide, and car accidents that we’ve started thinking they’re normal?

There’s an amusing anecdote in The English Gentleman, a humourous exposé of English upper-class life by Douglas Sutherland. In it, the author instructs us on the various ways one might master gentlemanly behaviour, from the dining hall to the hunting field:

He must also realise that once he is in the saddle he must be as rude as possible to anyone who crosses his path. One quasi-gentleman, when he was asked by the Master what the devil he thought he was doing out hunting, was naïve enough to reply that he only came out for the fresh air and exercise. ‘In that case you had better go home and bugger yourself with a pair of bellows,’ thundered the Master, riding off in pursuit of another victim for his scorn (91).

I mention this for two reasons: one is that in 1978, when the book was published, it was a natural response to the question of what one is doing outside: fresh air and exercise. The fact that the ‘quasi-gentleman’ answered without thinking allowed the ‘Master’ to take advantage of the idiom, which I (growing up in the 1970s) heard all the time from my mother as she closed the screen door behind me and sent me out into the world. I was not to come back until lunch time, after which I would be out again until dark. This seems, sadly, no longer to be the case for our young people .

The second is that we have, if you will pardon the expression, well and truly buggered ourselves on this front. Somehow, my generation, ignoring our own childhood experiences of endless summer days, independent adventure, creativity, and blissful activity outdoors for its own sake, have transformed the notion of ‘outside’ from “the natural and salubrious habitat of a child” to “the weird and unnatural habitat of paedophiles and/or early death”. In a single generation, it seems that the natural “roaming range” of a child at play has declined to one-ninth its former area! Have a look at this unsettling picture, from Britain’s Daily Mail:

This trend seems to be accelerating: the percentage of Canadian kids who play outside after school has dropped 14% over the last decade alone, and 46% of Canadian kids now get 3 hours or less of active play per week, including weekends.

The consequences of this sudden trend to raise children in captivity to children’s mental and physical health have been enormous and well documented. For complex social reasons, children are now subject to restrictions on their movements and activities that outnumber those of incarcerated felons. In one of the worst examples of Newspeak that I have witnessed, we justify our shameful treatment of young people by claiming that it is in their best interest.

Many go so far as to blame children for being lazy: the typical response of colonisers to the colonised. Create conditions that are so unhealthy and oppressive that, in order to survive, the victims adapt and change their behaviour. Then blame them for that behaviour and use it to justify further control and oppression.

Kids are not naturally lazy. In a recent global study, playing outside with friends was the single most popular choice of activity for children around the world. They don’t want to just sit quietly, allaying their parents’ worries: depression rates in children are skyrocketing. They’re fatter, sicker, stiller and sadder than any kid in history. In Canada, 92% of kids say they would rather play outside than watch TV. So why, why, why are they spending on average almost 8 hours a day in front of screens – as much time as you or I might spend at a full-time job??

The answer: Parental anxiety. Parents’ fears for children’s safety have turned them into (in the words of one child welfare spokesperson in the U.K.) “Battery chickens”. These parental fears are almost totally uncalled for. As experts have repeatedly pointed out, contrary to media-distorted perception, the world is not becoming more dangerous. Crime levels are at or below the idyllic levels of Baby-Boomer childhood days. Violent crime is especially low, as is death from disease or accident. We are the safest people ever to walk the planet, as Stephen Pinker points out in this TED talk:

In fact, we’re so safe it’s becoming dangerous. Everyone has seen for themselves that “kids are getting fatter these days”. But that seems sort of benign, next to the horrific fears of pedophile abduction that popular culture forces on the imaginations of parents everywhere. So let’s look at the consequences of sedating our children.

PHYSICAL CONSEQUENCES

In short, inactivity is killing our children slowly. The New England Journal of Medicine reports that, for the first time in history, our children’s lifespan could be 2-5 years less than our own. This is despite the fact of our increasing safety, mentioned above, and despite the fact that this appears to be entirely avoidable: fit individuals outlive unfit individuals across the board, including all causes of death. Regular physical activity is associated with as much as a 30% reduction in all causes of mortality.

Some fun facts from the ParticipACTION site (remember them? I used to have a jacket sewn all over with medals of theirs…one of my proudest moments as a kid was earning a gold one year):

• The number of obese children has tripled in the last 3 decades.

• That means that 26% of our kids are overweight or obese. That’s 1 in 4. By the time they reach adulthood, that same percentage will be fully obese.

• Sport participation rates in Canadian youth aged 15-18 declined from 77% in 1992 to 59% in 2005. Adults continue the trend: Canadian adult participation in sport declined from 45% in 1992 to 28% in 2005.

• What is killing our kids? Car accidents, mostly. But if they make it to adulthood, it’s heart disease, possibly cancer. Inactivity contributes strongly to more than 25 chronic conditions, many of which are potentially fatal: coronary heart disease, stroke, hypertension, breast cancer, colon cancer, type 2 diabetes and osteoporosis.

• The link is strong, and causal: inactivity doesn’t just exacerbate illnesses – it causes them. Physical inactivity is estimated to cause 21-25% of breast cancers and colon cancers, 27% of diabetes and 30% of ischemic heart disease.

• Physical inactivity – let’s be clear – is deadly. It is one of the five leading global risk factors for mortality and is estimated to cause 2 million deaths per year. Now a paper in the prestigious medical journal the Lancet is calling for exercise to be listed as a vital sign, alongside pulse and respiratory rate.

• For the first time in history, obesity is responsible for more deaths than being underweight, worldwide.

• This is, by all normal definitions, an epidemic. And a big one. In lower-income countries, it is comparable to two of the biggest, scariest health scourges on Earth: HIV/AIDS and tuberculosis. And yet, we’re apparently doing nothing about it. This is despite the fact that, repeatedly, Health Care is reported to be the #1 topic of concern to Canadians.

Even if you define ‘concern’ as merely referring to the cost associated with it, we’re being obtuse. The estimated costs of obesity and physical inactivity are as high as $7.1 billion a year, as of 2008. Add in the costs associated with reduced productivity, and you’ve got what should be a massive financial incentive to get our kids outside.

MENTAL CONSEQUENCES

Children are experiencing depression and anxiety at earlier ages than ever before. Now, Statistics Canada has found that 6.5% of youth and young adults between 15 and 24 had major depression last year. That’s more than 250, 000 kids. I recently attended a mental health seminar at the school I work at in Ontario. We were told that, out of a population of 1500, four students know a peer who has committed suicide in the last year. In terms of the whole city, in a population of around 22 500 high school students, 48.7% of male students and 47.9% of females had experienced depression during their high school careers; 45% of the males had never admitted it to anyone, suggesting that the alarming rates of teen depression in the news are actually underreported.

I can’t help but feel that the answer to these problems is the same one my mum had, all those years: Fresh air and exercise. And there’s a growing body of research to back her up. Let’s break it down:

FRESH AIR

Defined as ‘being outside in nature’. Parental fear of strangers and traffic have contributed to the decline of unstructured, unsupervised, outdoor play. 71 % of today’s mothers said they recalled playing outdoors every day as children, but only 26 % of them allow their kids to play outdoors daily. Most Canadians (75%) got their primary opportunities to experience the outdoors through school programmes, many of which are now being cut. Even recess has become a thing of the past in many schools in North America.

So few kids get out into nature these days that Richard Louv has coined the term “Nature Deficit Disorder” to describe the array of symptoms that could be allayed or eliminated with more contact with the natural world. These include:

These are over and above the benefits of just plain ol’ exercise, and the reduction of obesity-related morbidity, mentioned above. In fact, exercise in a natural setting seems to have more benefits than exercise alone – even the sight of green spaces through a hospital window has been linked to faster recovery times from surgery! The Proceedings of the National Academy of Science posits a direct relationship between biodiversity and human mental health. Even five minutes of exposure to nature has significant positive mental/emotional impact.

EXERCISE

The benefits are huge, and the drawbacks are nonexistent. Why do we not just do this? Remember, kids want exercise. All we have to do is get out of their way. Seriously: that might be it. We might be able to cure one of the biggest epidemic health threats to our children just by calming the hell down and stepping back. According to Dr W.H. Dietz,

Opportunities for spontaneous play may be the only requirement that young children need to increase their physical activity. Reducing the amount of time that children are allowed to watch television is one strategy that offers children opportunities for activity, and it is likely to alter requests for advertised foods as well.

The physical advantages of exercise should be obvious; what might not be so blatant are the psychological, neurological, and cognitive benefits it confers. I previously reported on an open letter by hundreds of mental health professionals across the world, calling on the return of unstructured, unsupervised play as a potential cure for many of the psychological woes suffered by our children these days.

But there’s more: lots more.

One of the ways that parents interfere with children’s fresh air and exercise is an inappropriate, status-driven obsession with academic performance. As is so often the case with these things, the obsessive behaviour actually brings about the very outcome they are trying to avoid. Regular exercise in fact increases attention, focus, memory, critical thinking, and overall cognitive ability.

Further to the treatment of ADD and ADHD by exposure to nature, discussed above, exercise has also been shown to have a positive effect .

It has been shown to increase brain function and (what is critical) plasticity, allowing for amazing advantages ranging from recovery from brain injury to increased ability to learn to a reduced risk of dementia.

Aerobic exercise has even been linked to neurogenesis: that is, it triggers the growth of new brain cells, something that people used to think was impossible. This was shown to have an effect even in the brains of depressed people, where it is normally reduced. The reduction of cortisol, a stress hormone, may be implicated in this.

It has also been shown to increase blood flow to the brain, which has an overall, generalised beneficial effect on executive cognitive function. Study subjects showed marked improvement in areas such as “tasks that require planning, working memory, multitasking, [and] resistance to distraction.” Mental exercises, by contrast, tend to be task-specific in the way they improve cognition.

Exercise prevents memory loss by reducing feelings of stress, anxiety and depression. It also has a positive effect on sleep patterns and insomnia in adolescents, which is at the root of all kinds of health and cognitive detriments.

After a study by a Harvard medical team, even our very own Canadian national emblem, the Mounties of the RCMP, have adopted a fitness programme for their officers – not to keep them fit so they can chase criminals, but specifically for the improvement of their cognitive functions. They’ve invested in fitness programmes for their inspectors to help them solve crimes.

So with all these common-sense, obvious, well-documented benefits of fresh air and exercise, how have we allowed our own groundless anxieties to rob our children of the world of nature, and possibly of their very future? I’ll explore some of that in my next post.